57 - Stroke

Question 1

2 types of stroke

Answer 1

ischemia: inadequate blood flow
hemorrhage: bleeding

Question 2

others terms for stroke

Answer 2

brain attack
CVA
cerebrovascular accident

Question 3

common long-tern disabilities of stroke

Answer 3

• hemiparesis
• inability to walk
• aphasia (no talk)
• depression
• partial/complete dependance on ADL

Question 4

2 types of brain arteries

Answer 4

1 internal carotid/anterior circulation

2 vertebral arteries/posterior circulation

Question 5

carotid supplies which part of the brain

Answer 5

frontal
parietal
temporal
diencephalon (thalamus/hypothalamus)
basal ganglia

Question 6

vertebral arteries supply which part of the brain

Answer 6

middle/lower temporal 
occipital
cerebellum
brainstem
part of diencephalon (thalamus/hypothalamus)

Question 7

ideal range for blood flow and CO for optimal brain function

Answer 7

750 1k mL/min

20% CO

Question 8

CO2

Answer 8

potent vasodilator in brain

-incr CO2 triggers an incr in CBF

Question 9

CO must be reduced by ____ before CBF is reduced

Answer 9

1/3

Question 10

increased ICP causes ___ + ___

Answer 10

brain compression + reduced CBF

Question 11

____is responsible for 25% of strokes

Answer 11

atrial fibrilation

Question 12

smoking nearly doubles the risk of _____ stroke

Answer 12

ischemic

Question 13

TIA

Answer 13

transient ischemic attack

Question 14

transient ischemic attack

Answer 14

episode of neurologic dysfunction

• caused by focal brain, spinal cord, or retinal ischemia
• WITHOUT acure infarction of the brain
• symtpms typically last 1 hr

Question 15

s/s if carotid system is involved w TIA…

Answer 15

-temporary vision loss in 1 eye aka
amaurosis fugax
-temp hemiparesis
-numb/loss of sensatn
-aphasia

Question 16

s/s if vertebrobasilar system is involved w TIA…

Answer 16

• tinnitus
• vertigo
• darkened/blurred vision

Question 17

stroke vs TIA

Answer 17

strokes have infarction

Question 18

2 types of ischemic strokes

Answer 18

thrombotic: injury to bld vssl + formation of bld clot
embolic: when an embolus lodges > occludes cerebral artery

Question 19

60% of strokes are

Answer 19

thrombotic

Question 20

is decr LOC a sign of ischemic stroke?

Answer 20

decr LOC is rare in first 24 hrs

Question 21

thrombotic vs embolic s/s

Answer 21

embolic has a more severe onset + manifestations

Question 22

common cause of embolic stroke in the young

Answer 22

rheumatic heart disease

Question 23

most common cause of intracerebral hemorrhage

Answer 23

HTN

Question 24

4 phases of a seizure

Answer 24

1 prodromal (senstn or bhvr chngs)
2 aural (sensory wrng each time seizure occurs, part of seizure)
3 ictal (1st sympt to end)
4 postictal (recovery)

Question 25

generalized onset seizure

Answer 25

starts over wide areas of both sides of the brain

Question 26

types of generalized onset seizure

Answer 26

tonic-clonic tonic clonic atonic

Question 27

tonic-clonic aka

Answer 27

grand mal

Question 28

most common type of generalized onset seizure

Answer 28

tonic-clonic/grand mal

Question 29

tonic-clonic/grand mal

Answer 29

- loses consciousness + falls - tonic (stiffens) for 20-30 sec - clonic (jerking) 30-40 sec

Question 30

tonic-clonic/grand mal | S/S

Answer 30

- cyanosis - excessv saliva - tongue/cheek biting - incontinence - no memory

Question 31

tonic

Answer 31

occurs most in sleep - boths sides of body stiffent - less than 20 sec

Question 32

clonic

Answer 32

- loss of awareness then loss of muscle tone - rhythmic jerking may or may not be symmetric - RARE

Question 33

atonic aka

Answer 33

drop attack

Question 34

atonic/drop attack

Answer 34

- suddenly w pt falling to the ground - less than 15 sec - stays conscious - risk of head injury

Question 35

absence seizure | s/s

Answer 35

mostly in children - staring spelling less than 10 sec is typical - atypical is slight jerks in mouth or blinks

Question 36

myoclonic

Answer 36

-rhythmic arm abductn (3 mvmt/second)

Question 37

psychogenic/nonepileptic disorder

Answer 37

NOT a seizure - needs an EEG to exclude seizure - may be due to emotional trauma (abuse/military)